scholarly journals Measuring Substance-Related Disorders Using Canadian Administrative Health Databanks: Interprovincial Comparisons of Recorded Diagnostic Rates, Incidence Proportions and Mortality Rate Ratios

2021 ◽  
pp. 070674372110434
Author(s):  
Christophe Huỳnh ◽  
Steve Kisely ◽  
Louis Rochette ◽  
Éric Pelletier ◽  
Kenneth B. Morrison ◽  
...  

Context Assessing temporal changes in the recorded diagnostic rates, incidence proportions, and health outcomes of substance-related disorders (SRD) can inform public health policymakers in reducing harms associated with alcohol and other drugs. Objective To report the annual and cumulative recorded diagnostic rates and incidence proportions of SRD, as well as mortality rate ratios (MRRs) by cause of death among this group in Canada, according to their province of residence. Methods Analyses were performed on linked administrative health databases (AHD; physician claims, hospitalizations, and vital statistics) in five Canadian provinces (Alberta, Manitoba, Ontario, Québec, and Nova Scotia). Canadians 12 years and older and registered for their provincial healthcare coverage were included. The International Classification of Diseases (ICD-9 or ICD-10 codes) was used for case identification of SRD from April 2001 to March 2018. Results During the study period, the annual recorded SRD diagnostic rates increased in Alberta (2001–2002: 8.0‰; 2017–2018: 12.8‰), Ontario (2001–2002: 11.5‰; 2017–2018: 14.4‰), and Nova Scotia (2001–2002: 6.4‰; 2017–2018: 12.7‰), but remained stable in Manitoba (2001–2002: 5.5‰; 2017–2018: 5.4‰) and Québec (2001–2002 and 2017–2018: 7.5‰). Cumulative recorded SRD diagnostic rates increased steadily for all provinces. Recorded incidence proportions increased significantly in Alberta (2001–2002: 4.5‰; 2017–2018: 5.0‰) and Nova Scotia (2001–2002: 3.3‰; 2017–2018: 3.8‰), but significantly decreased in Ontario (2001–2002: 6.2‰; 2017–2018: 4.7‰), Québec (2001–2002: 4.1‰; 2017–2018: 3.2‰) and Manitoba (2001–2002: 2.7‰; 2017–2018: 2.0‰). For almost all causes of death, a higher MRR was found among individuals with recorded SRD than in the general population. The causes of death in 2015–2016 with the highest MRR for SRD individuals were SRD, suicide, and non-suicide trauma in Alberta, Ontario, Manitoba, and Québec. Discussion Linked AHD covering almost the entire population can be useful to monitor the medical service trends of SRD and, therefore, guide health services planning in Canadian provinces.

2000 ◽  
Vol 6 (2-3) ◽  
pp. 283-293
Author(s):  
M. Legnain ◽  
R. Singh ◽  
M. O. Busarira

We conducted a clinicoepidemiological study of 14 maternal deaths out of 79 981 live births at Al-Jamahiriya Hospital, Benghazi between 1993 and 1997. The maternal mortality rate per 100 000 live births was 17.5. The reproductive profile of these women was: mean age 31.5 +/- 6.9 years, mean parity 4.5, mean birth interval 14.6 +/- 7.0 months, mean gestation 27.7 +/- 14.6 weeks and mean haemoglobin 9.3 +/- 2.1 g/dL. None of the women had prebooked their delivery, 50% had preconceptional medical or obstetric risk factors, around 70% were anaemic, almost all were admitted with serious medical conditions and > 50% required surgical intervention. The main underlying medical causes of death were: hypertensive disease of pregnancy [28.6%], haemorrhage [14.3%], pulmonary embolism [14.3%]and brain tumour [14.3%]


2018 ◽  
Vol 25 (8) ◽  
pp. 1092-1101 ◽  
Author(s):  
José MA Wijnands ◽  
Feng Zhu ◽  
Elaine Kingwell ◽  
Yinshan Zhao ◽  
Okechukwu Ekuma ◽  
...  

Background: The multiple sclerosis (MS) prodrome is poorly characterized. Objective: To phenotype the MS prodrome via health care encounters. Methods: Using data from a population-based cohort study linking administrative and clinical data in four Canadian provinces, we compared physician and hospital encounters and prescriptions filled (via International Classification of Diseases chapters, physician specialty or drug classes) for MS subjects in the 5 years before the first demyelinating claim in an administrative cohort or the clinical symptom onset in an MS clinic-derived cohort, to age-, sex- and geographically matched controls. Rate ratios (RRs), 95% confidence intervals (95% CIs) and proportions were estimated. Results: The administrative and clinical cohorts included 13,951/66,940 and 3202/16,006 people with and without MS (cases/controls). Compared to controls, in the 5 years before the first demyelinating claim or symptom onset, cases had more physician and hospital encounters for the nervous (RR (range) = 2.31; 95% CI: 1.05–5.10 to 4.75; 95% CI: 3.11–7.25), sensory (RR (range) = 1.40; 95% CI: 1.34–1.46 to 2.28; 95% CI: 1.72–3.02), musculoskeletal (RR (range) = 1.19; 95% CI: 1.07–1.33 to 1.70; 95% CI: 1.57–1.85) and genito-urinary systems (RR (range) = 1.17; 95% CI: 1.05–1.30 to 1.59; 95% CI: 1.48–1.70). Cases had more psychiatrist and urologist encounters (RR (range) = 1.48; 95% CI: 1.36–1.62 to 1.80; 95% CI: 1.61–2.01), and higher proportions of musculoskeletal, genito-urinary or hormonal-related prescriptions (1.1–1.5 times higher, all p < 0.02). However, cases had fewer pregnancy-related encounters than controls (RR = 0.78; 95% CI: 0.71–0.86 to 0.88; 95% CI: 0.84–0.92). Conclusion: Phenotyping the prodrome 5 years before clinical recognition of MS is feasible.


CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S100-S100
Author(s):  
J. French ◽  
C. Somayaji ◽  
D. Dutton ◽  
S. Benjamin ◽  
P. Atkinson

Introduction: The New Brunswick Trauma Registry is a database of injury admissions from eight hospitals throughout the province. Data tracks individuals in-hospital. By linking this information with vital statistics, we are able to observe outcomes post-discharge and can model health outcomes for participants. We want to know how outcomes for trauma patients compare with the general population post discharge. Methods: Using data from 2014-15, we followed over 2100 trauma registry observations for one year and tracked mortality rate per 1,000 people by age-group. We also compared the outcomes of this group to all Discharge Abstract Database (DAD) entries in the province (circa. 7500 total). We tracked mortality in-hospital, at six months, and one year after discharge. We truncated age into groups aged 40-64, 65-84, and 85 or older. Results: In-hospital mortality among those in the trauma registry is approximately 20 per 1,000 people for those age 40-64, 50 per 1,000 people for those aged 65-84, and 150 per 1,000 people aged 85 or older. For the oldest age group this is in line with the expected population mortality rate, for the younger two groups these estimates are approximately 2-4 times higher than expected mortality. The mortality at six-month follow-up for both of the younger groups remains higher than expected. At one-year follow-up, the mortality for the 65-84 age group returns to the expected population baseline, but is higher for those age 40-64. Causes of death for those who die in hospital are injury for nearly 50% of observations. After discharge, neoplasms and heart disease are the most common causes of death. Trends from the DAD are similar, with lower mortality overall. Of note, cardiac causes of death account for nearly as many deaths in the 6 months after the injury in the 40 -64 age group as the injury itself. Conclusion: Mortality rates remain high upon discharge for up to a year later for some age groups. Causes of death are not injury-related. Some evidence suggests that the injury could have been related to the eventual cause of death (e.g., dementia), but questions remain about the possibility for trauma-mitigating care increasing the risk of mortality from comorbidities. For example, cardiac death, which is largely preventable, is a significant cause of death in the 40-64 age group after discharge. Including an assessment of Framingham risk factors as part of the patients rehabilitation prescription may reduce mortality.


2008 ◽  
Vol 61 (9-10) ◽  
pp. 503-506
Author(s):  
Nevenka Roncevic ◽  
Aleksandra Stojadinovic

Introduction. Adolescents are the healthiest age group of the population but many studies show that period of adolescence is marked by significant morbidity and mortality. Health indicators of adolescent population have been getting worse during past decades. The aim of this study was to determine mortality rate of adolescents in the Republic of Serbia to determine most common causes of death in adolescence and to explore regional differences in adolescent mortality. Materials and methods: Documentation tables of vital statistics in the Republic of Serbia in 2004, and Documentation Tables of Census 2002 were used. The causes of mortality were classified according to ICD 10. Results and discussion. Specific morality rate in the Republic of Serbia is 32.08 on 100.000 adolescents. The leading causes of death in adolescence are injuries, malignancies and non specified causes, and there are significant regional differences, as well as gender and age differences. The mortality rate of male adolescents is about 2.4 times higher than the mortality rates in female adolescents. The mortality rate of older adolescents is significantly higher than mortality rate of younger adolescents. The mortality of adolescents is higher in Vojvodina than in Central Serbia. Precise data of external causes of death do not exist in vital statistics in our country. Conclusion. The mortality of adolescents is high, especially for older male adolescents (15 to 19 years of age) and majority of deaths among adolescents could be prevented. It is necessary to improve data of vital statistics to get better insight into causes of adolescent death.


BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e026210
Author(s):  
Kaja Rahu ◽  
Mati Rahu ◽  
Hajo Zeeb

ObjectivesTo quantify sex disparities in cause-specific premature adult mortality in Estonia, to determine the causes of death with the largest differences, to provide insight into related behaviours and to offer some guidance to public health policy-makers based on the results of the study.DesignA national register-based study.SettingEstonia.DataIndividual records of deaths at ages 20–69 years in 1995–2016 from the Estonian causes of death register; data on tobacco smoking and alcohol consumption in the adult population in 1996–2016 from the biennial postal survey of health behaviour.Main outcome measuresOverall and cause-specific age-standardised mortality rates, average annual percentage changes in mortality, and cause-specific men-to-women mortality rate ratios were calculated. In addition, the age-standardised prevalence proportions of tobacco smoking and alcohol consumption and men-to-women prevalence rate ratios were determined.ResultsOverall premature adult mortality decreased considerably during 1995–2016, but no reduction was observed with respect to the large relative sex disparities. In circulatory disease mortality, the disparities widened significantly over time. Extremely high mortality rate ratios were observed for cancer of the upper aerodigestive tract and for lung cancer. There was a stable, more than fivefold male excess mortality from external causes. A fourfold male disadvantage was evident for alcohol poisoning, mental disorders due to alcohol and alcohol-related degeneration of the nervous system as a group. The prevalence of tobacco smoking and harmful alcohol consumption among men exceeded that among women by factors of two and six, respectively.ConclusionsEven though premature adult mortality has markedly decreased over time, there has been no success in diminishing the large sex differences in the mortality patterns, mostly associated with smoking and excessive alcohol consumption, both more prevalent among men. Estonia needs a comprehensive and consistent alcohol policy while maintaining and further developing antitobacco measures.


Author(s):  
Silvia María Méndez Maín ◽  
◽  
Andrea V. Rivas Méndez ◽  

This article is devoted to a detailed analysis of death causes in Mexico during the Revolution and Civil War period. Our study is based on the death registration records in six government-controlled municipalities in Veracruz State which promoted registration accuracy. A total of 2 876 records from 1918 were analyzed, most of which contained information about the causes of death. The main objectives of the study were to determine the main causes of death, to identify territorial, age and gender differences, to establish the time and extent of the spread of the Spanish flu epidemic and the overall mortality rate in 1918. The 10th revision of the International Classification of Diseases (ICD-10), developed by the World Health Organization, was used as a basis for coding the causes of death. Thus, the causes of diseases that led to the death of the inhabitants of Veracruz were divided into eight main classes: infectious; respiratory; related to pregnancy or childbirth; those caused by difficulties in the perinatal period of fetal development; external violent reasons; unclassifiable, those associated with infancy and childhood; the unclassifiable; and finally, the missing. The analysis revealed registration problems, especially in the agrarian regions, caused by the poor development of medical infrastructure and aggravated by wartime conditions. Based on the analysis of individual level data on the causes of death, the authors identified the 161 diagnostic options found in the sources, identified the main ten death causes for each of the six cities of Veracruz, determined the level and accuracy of registration and the age characteristics of the spread of certain classes of fatal diseases. The most common cause of death was infectious diseases, particularly children from one to five years old suffered from these. The rate of respiratory diseases was also high, the proportion of deaths from these rose sharply in the last quarter of 1918, which was caused by the spread of the Spanish flu. The analysis of the nominative data made it possible to refute the official statement of the Mexican government about the cessation of influenza at the end of 1918. The high mortality rate from various respiratory diseases in December 1918 among young men suggests that the flu pandemic was hidden behind various other concepts.


PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0252106
Author(s):  
Reuben Musarandega ◽  
Rhoderick Machekano ◽  
Robert Pattinson ◽  
Stephen Peter Munjanja ◽  

Background Sub-Saharan Africa (SSA) carries the highest burden of maternal mortality, yet, the accurate maternal mortality ratios (MMR) are uncertain in most SSA countries. Measuring maternal mortality is challenging in this region, where civil registration and vital statistics (CRVS) systems are weak or non-existent. We describe a protocol designed to explore the use of CRVS to monitor maternal mortality in Zimbabwe—an SSA country. Methods In this study, we will collect deliveries and maternal death data from CRVS (government death registration records) and health facilities for 2007–2008 and 2018–2019 to compare MMRs and causes of death. We will code the causes of death using classifications in the maternal mortality version of the 10th revision to the international classification of diseases. We will compare the proportions of maternal deaths attributed to different causes between the two study periods. We will also analyse missingness and misclassification of maternal deaths in CRVS to assess the validity of their use to measure maternal mortality in Zimbabwe. Discussion This study will determine changes in MMR and causes of maternal mortality in Zimbabwe over a decade. It will show whether HIV, which was at its peak in 2007–2008, remains a significant cause of maternal deaths in Zimbabwe. The study will recommend measures to improve the quality of CRVS data for future use to monitor maternal mortality in Zimbabwe and other SSA countries of similar characteristics.


2020 ◽  
Vol 29 ◽  
Author(s):  
C. Blanner ◽  
A. Mejldal ◽  
A. M. Prina ◽  
P. Munk-Jørgensen ◽  
A. K. Ersbøll ◽  
...  

Abstract Aims Widowed people have increased mortality compared to married people of the same age. Although most widowed people are of older age, few studies include the oldest old. As life expectancy is increasing, knowledge of widowhood into older age is needed. This study aimed to examine mortality and widowhood in older age by comparing mortality in widowed and married people by sex, age, time since spousal loss and cause of death. Methods A Danish register-based matched cohort study of 10% of widowed persons ⩾65 years in the years 2000–2009. For each randomly drawn widowed person, five married persons were matched on sex and age. Mortality rate ratios (MRR) were calculated using Poisson regression, and stratified according to sex and 5-year age intervals. MRRs were furthermore calculated by time since spousal loss and by specific cause of death. Results The study included 82 130 persons contributing with 642 914.8 person-years. The overall MRR between widowed and married persons with up to 16 years of follow-up was 1.25 (95% CI 1.23–1.28). At age ⩾95 years for men, and ⩾90 years for women, no differences in mortality rates were seen between widowed and married persons. Mortality in widowed persons was increased for most specific causes of death, with the highest MRR from external causes (MRR 1.53 [1.35–1.74]) and endocrine diseases (MRR 1.51 [1.34–1.70]). Conclusions Widowhood was associated with increased mortality in older age for both men and women until age ⩾95 and ⩾90 years, respectively. Increased mortality was observed for almost all causes of death.


2007 ◽  
Vol 1 (1) ◽  
pp. 15-20 ◽  
Author(s):  
Kevin U. Stephens ◽  
David Grew ◽  
Karen Chin ◽  
Paul Kadetz ◽  
P Gregg Greenough ◽  
...  

ABSTRACTBackground: Reports that death notices in the Times-Picayune, the New Orleans daily newspaper, increased dramatically in 2006 prompted local health officials to determine whether death notice surveillance could serve as a valid alternative means to confirm suspicions of excess mortality requiring immediate preventive actions and intervention.Methods: Monthly totals of death notices from the Times-Picayune were used to obtain frequency and proportion of deaths from January to June 2006. To validate this methodology the authors compared 2002 to 2003 monthly death frequency and proportions between death notices and top 10 causes of death from state vital statistics.Results: A significant (47%) increase in proportion of deaths was seen compared with the known baseline population. From January to June 2006, there were on average 1317 deaths notices per month for a mortality rate of 91.37 deaths per 100,000 population, compared with a 2002–2004 average of 924 deaths per month for a mortality rate of 62.17 deaths per 100,000 population. Differences between 2002 and 2003 death notices and top 10 causes of death were insignificant and had high correlation.Discussion: Death notices from local daily newspaper sources may serve as an alternative source of mortality information. Problems with delayed reporting, timely analysis, and interoperability between state and local health departments may be solved by the implementation of electronic death registration. (Disaster Med Public Health Preparedness. 2007;1:15–20)


2020 ◽  
Vol 36 (4) ◽  
pp. 933-941
Author(s):  
Sofoora Kawsar Usman ◽  
Sheena Moosa

An efficient Civil Registration and Vital Statistics (CRVS) system is a development imperative. Data on death registration and causes of death are important for measuring health outcomes. This paper evaluates the completeness and quality of data on death registration and causes of death (CoD) based on analysis of the registration records on death and causes of death for the period 2009–2018. Using established methods and approaches, we observed that CRVS system performed well on death registration completeness, quality of age and sex reporting. However, the quality of cause of death data was poor with 50% of the International Classification of Diseases (ICD) codes classified as “major garbage codes” and significant time lag was observed in the transmission and production of vital statistics. The CRVS system in Maldives is complete with all deaths occurring within its territory registered and causes of death recorded. The two areas that require attention are the time taken for publication of vital statistics and quality of cause of death reporting. Appropriate re-engineering of the existing business process can build real-time mortality data, and regular quality assessment of death certificates with feedback to health facilities can bring sustained improvements in quality of vital statistics.


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